Psoriasis

Question 1

what can precipitate psoriasis

Answer 1

medications - beta blockers, lithium, antimalarials and withdrawal of topical or systemic steroids
trauma - koebner phenomenom
smoking
HIV/AIDS

Question 2

what is auspitz sign

Answer 2

removing scale reveals pin point bleeding

Question 3

nail changes seen in psoriasis

Answer 3

pitting
onycholysis
oil drop lesions
subungual hyperkeratosis

Question 4

in general the best first line treatment of psoraisis is

Answer 4

topical - usually vit D analogue would be first choice as its the best tolerated

Question 5

other topical treatments of psoriais are

Answer 5

tar
vit D analogue
Salicylic acid
dithranol
topical steroids - not used often as concerns of reboun flare but can be used in flexural or face psoriasis or as a combo with vit D analogue

Question 6

what types of phototheray can be used in psoriasis

Answer 6

UVB

or PUVA = psoralen and UV A radiation

Question 7

what systemic therapies are used in psoriais

Answer 7

methotrexate
ciclosporin
biologics -etanercept, anti TNF
retinoids - can combine with phototherapy
fumeric acid esters

Question 8

adverse effects of phototherapy

Answer 8

erythema
blistering
photoconjunctivitis
exacerbations of herpes simplex virus

photoageing and photocarcinogenesis in longer term

Question 9

what is the typical history in guttate psoriasis

Answer 9

tear drop plaques occuring after a sore throat in usually younger patients aged 15-25

Question 10

how do you treat flexural psoriasis

Answer 10

generally a combo mild steroid and anti fungal such as canesten HC or trimovate

Question 11

what treatment is often needed in palmoplantar psoriasis

Answer 11

salycilic acid due to hyperkeratosis